Attachment A.1 - Medical PCR (SF and ES).pdf
PDF 221 KB Posted
- Attached to
- Peterson and Schriever SFB Ambulance Services Federal contract opportunity
- Solicitation number
- FA251725R0013
About this file
This is a Patient Care Report (PCR) template for Schriever Fire & Emergency Services, designed to capture comprehensive medical incident documentation. The form includes sections for incident details, demographic information, medical information, vital signs, O2/Airway procedures, medication administration, and a narrative section. It provides spaces to record critical information such as call times, patient identification, medical complaints, past medical history, allergies, medications, vital signs (blood pressure, heart rate, respiratory rate, oxygen saturation), and specific medical interventions performed during the emergency response. The template is structured to ensure thorough documentation of emergency medical service encounters, with designated areas for EMT/EMR technician and reviewer signatures.
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Text version
SCHRIEVER F&ES PCR
Date: Call Time: Units Dispatched: En-route: Arrive Scene:
Arrive Patient: Termination: Incident #:
Incident Location:
Demographic Information
Medical Information Chief Complaint: Secondary Complaint:
PMHx: Allergies:
Meds:
Onset: Sudden Provocation:
Quality: Radiation: Severity: Time:
Vital Signs Time BP HR RR SpO2 BGL Skin Pupils EKG
O2/Airway Medication Time Procedure O2 ETT S/U By Time Name Dose Route Response By
Narrative
EMT/EMR Tech: ______________________________ Reviewed By: ____________________________
Last Name: First Name: M.I: Male Female DOB: Age: Military Civilian Rank: CIV Unit:
Address:
City : State: Zip Code:
File details come from the government source that posted it. Updated .